Individual
EVAN R. KOKOSKA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
2001 W. 86TH STREET, PEDIATRIC HOSPITAL, INDIANAPOLIS, IN 46260
(317) 338-8857
(317) 338-8858
Mailing address
2001 W 86TH ST, PEDIATRIC HOSPITAL, INDIANAPOLIS, IN 46260-1902
(317) 338-8857
(317) 338-8858
Taxonomy
Speciality
Code
Description
License number
State
2086S0120X
Pediatric Surgery Physician
Primary
01053703A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
150489001
—
AR
Enumeration date
10/13/2006
Last updated
09/08/2010
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